PrEP Update: The Facts Speak for Themselves, Notes AHF

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Statistics exposing the low uptake on PrEP regarding how few people
really are on PrEP were presented by Gilead at the American Society for
Microbiology Conference in June. In response, AHF rolls out a new
national ad campaign challenging the hype versus reality on pre-exposure
prophylaxis for HIV prevention.

AHF’s ‘Open Letter to the CDC on PrEP’ ad campaign starts this week
in seven US markets or cities nationwide: New York, Los Angeles, San
Francisco, Atlanta, Dallas, Washington, DC and South Florida.

The catalyst for AHF’s “Open Letter” advocacy ad is the apparent lack of
interest in, and low uptake of PrEP by both patients and medical
providers, according to damning statistics provided directly from Gilead
that it presented at the American Society for Microbiology (ASM)Conference
in June of this year. In a research presentation titled, “Racial
Characteristics of FTC/TDF for Pre-exposure Prophylaxis (PrEP) Users in
the US,” Gilead reported that just over 49,000 total cumulative
prescriptions for Truvada as PrEP have been filled in the US since the
FDA first approved use of Truvada as PrEP four years ago. (49,148 total
cumulative prescriptions based on data reported by 82% of all pharmacies
from January 1, 2012 through September 30, 2015.)

AHF created the advocacy ad to raise awareness about effective HIV and
STD prevention strategies, particularly in light of simultaneous skyrocketing
rates of STDs reported by the CDC (and for which PrEP offers no
preventive protection or benefit) among young people, gay men and men
who have sex with men (MSM) that suggest a widespread abandonment of the
culture of condom use. A Guardian
news article published July 5th cited similar Public
Health England (PHE) research showing a dramatic and parallel
increase in STDs in the same populations in England between 2012 and
2015.

AHF’s ad, written in the form of an open letter to the CDC, first
appeared Wednesday, July 20th in the South Florida Gay News
(SFGN) and will start running today (7/21) and tomorrow (7/22) in six
other markets nationwide over the next week.

“Regarding the hype versus the reality on PrEP, we have Gilead to thank
for letting the facts speak for themselves, thanks to its comprehensive
research presented in Boston last month on actual PrEP usage and
uptake,” said Michael Weinstein, President of AHF. “Gilead’s own
research shows that despite the tremendous hype, uptake of PrEP has been
abysmally low and that it is not reaching those most at risk. The
concurrent explosion of STDs among populations targeted for PrEP
suggests an abandonment of the culture of condoms. Taken together, these
are not good indicators of prudent and effective public health
strategies for HIV and STD prevention. We need to recalibrate and
rebalance prevention efforts to align with what patients want and need
so that we can all achieve better success in preventing new infections.”

Under the headline ‘An Open Letter to the CDC on PrEP,’ AHF’s ad
reads:

Four years ago on July 16, 2012, the Food and Drug Administration
approved use of Truvada for the prevention of HIV, which is also known
as Pre-Exposure Prophylaxis (PrEP)1. In a
report released by Gilead Sciences on June 20, 2016, they revealed the
following information:

1. 49,148 total cumulative prescriptions for Truvada as PrEP have
been filled based on data reported by 82% of all pharmacies. While it is
unknown how many people who were originally prescribed the drug are
still on it, based on adherence information in previous studies, no more
than half the people actually took the drug on any type of consistent
basis2. Therefore, we estimate that about
25,000 are still taking Truvada for prevention. Of these patients 79%
were men or about 20,000.

2. We are assuming almost all of these 20,000 are men who have sex
with men (MSM). Studies estimate that there are 4,875,000 MSM3—or 3.9% of the 125 million adult men in the US. As a result, we can
conclude that less than .04% of MSM are taking Truvada for PrEP. CDC has
suggested that 1.2 million men4should be on
PrEP but doctors and patients are not responding to that call in large
numbers. PrEP cannot be a major factor in preventing HIV when so few
people are on it. On the other hand recent studies indicate that 60% of
MSM use condoms regularly5, based on last sex
among HIV-negative MSM.

3. African-Americans are 12% of the US population but are 44% of new
HIV infections6. However, they are only 10% of
people on PrEP.Young people are most at risk for new HIV
infections, but made up only 7.6% of PrEP prescriptions. Whites
represent 27% of new infections but made up 74% of those on PrEP. The
men who are taking PrEP are those least at risk from HIV.

4. PrEP does not protect people from STDs. The rapid rise in rates of
STDs such as syphilis, chlamydia and gonorrhea7
indicate that fewer people are using condoms and suggesting the need to
reinvigorate safer sex campaigns, which have suffered greatly as a
result of the CDC’s almost exclusive focus on PrEP.

5. The wide-scale advertising promotions of Truvada for PrEPby
AIDS organizations and community groups funded by the manufacturer
Gilead Sciences gives the impression that PrEP is very popular even
though the raw numbers tell another story. Based on the large number of
men who say they are on PrEP on hook-up sites such as Grindr, it would
appear that they are seeking unprotected sex whether they take the drug
or not.

The CDC is the national agency
responsible for the prevention of HIV and other STDs. As such, we call
on you to rebalance your prevention efforts to align with what patients
want and need so that we can achieve better success in preventing new
infections.

Gilead’s Supplemental New Drug application (SNDa) to the FDA for use of
its AIDS treatment Truvada for HIV prevention was approved four years
ago on July 16, 2012. In May 2014, shortly before the International AIDS
Conference in Melbourne, Australia, the CDC issued a public
recommendation that 500,000 high-risk individuals in the United States
go on PrEP. On November 24,2015, the CDC revised its
recommendation upward, suggesting that 1.2 million people—including one
in four gay men— go on PrEP.

AIDS Healthcare Foundation (AHF), the largest global AIDS
organization, currently provides medical care and/or services to over
666,000 individuals in 36 countries worldwide in the US, Africa, Latin
America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn
more about AHF, please visit our website: www.aidshealth.org,
find us on Facebook: www.facebook.com/aidshealth
and follow us on Twitter: @aidshealthcare
and Instagram: @aidshealthcare.